Provider Demographics
NPI:1063624393
Name:CHARLES A. CRAWFORD D.D.S.
Entity type:Organization
Organization Name:CHARLES A. CRAWFORD D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:A
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-237-9008
Mailing Address - Street 1:1031 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-7801
Mailing Address - Country:US
Mailing Address - Phone:614-237-9008
Mailing Address - Fax:614-237-0036
Practice Address - Street 1:1031 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209-7801
Practice Address - Country:US
Practice Address - Phone:614-237-9008
Practice Address - Fax:614-237-0036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental